ASTHMA WATCH

Tutorial Educates on Proper Inhaler Use

A new Web-based tutorial is now available to educate
patients with lung disease about how to take their inhalation
medications correctly.

The American Association for Respiratory Care (AARC),
which launched the free tutorial, said that using the wrong
inhaler during a respiratory attack could be deadly and recommended
that patients place a large "X" on their rescue
medication so they can immediately identify the correct
inhaler. Another issue for patients is knowing when their
inhalers have run out of medicine. There are 200 actuations
in an albuterol canister, and the FDA recommends keeping
count through a diary. The AARC also recommends purchasing
a dose meter at the pharmacy to help track medications.

Whereas the asthma patient will use 2 inhalers, a typical
patient with chronic obstructive pulmonary disease will use
4 inhalers. Each medication works differently and needs to
be taken as prescribed to work properly. The tutorial can be
found at www. YourLungHealth.org.

Caregivers' Mental Health ImpactsKids' Asthma Treatment

Asthmatic children whose caregivers suffer from mental
health problems are more likely to be hospitalized, according
to a study reported in Pediatrics (December 2006).

The current study analyzed how a caregiver's mental
health may impact a child's asthma treatment. The researchers
assessed the psychiatric symptoms in 175 caregivers
of children hospitalized for asthma. The study found
that almost 27% of caregivers were currently experiencing
depression, while 20.6% were experiencing an anxiety disorder.
Children whose caregivers scored high on 2 or more
tests for mental health symptoms had been hospitalized
64% more often for asthma, compared with those whose
caregivers scored lower. The findings also indicated that
children whose caregivers were depressed had more
impromptu clinic visits, while children whose caregivers
had an anxiety disorder were hospitalized more often.

Be S.A.F.E. Campaign Focuses on Anaphylaxis

The American College of Allergy, Asthma, and Immunology
(ACAAI) and the American College of Emergency Physicians
(ACEP) have launched the Be S.A.F.E. campaign to increase
awareness of anaphylaxis.

A panel of allergists and emergency physicians recommended
the creation of a quick reference card for emergency physicians.
The card provides information about anaphylaxis diagnosis,
duration of patient observation, and suggested physician
and patient resources. It also includes the S.A.F.E. system:

Seek Support

Allergen Identification and Avoidance

Follow up for Specialty Care

Epinephrine for Emergencies

The reference card and additional information about the Be
S.A.F.E. campaign can be found in the Health Professionals
section of the ACAAI Web site at www.acaai.org.

New Tool Helps Pinpoint Acute Asthma Cases

The Epidemiology and Natural History of Asthma: Outcomes
and Treatment Regimens Risk Score may help improve the care
of patients with asthma and reduce costs. The new clinical tool
determines the hardest-to-treat cases by evaluating factors
such as the patient's age, weight, smoking status, medical history,
medications and breathing, and exercise tests. The early
intervention tool is useful for assessing the possibility of asthma-
related hospitalization or emergency room visits.

During the 3-year study, the researchers collected data and
assigned scores ranging from 0 to 18 to about 2821 patients.
The researchers found that patients with a moderate risk score
of 5 to 7 points had a 3.5-fold increased risk of requiring hospital
treatment. A score of 8 points or more showed a 12-fold
higher risk, compared with patients with a low score of 0 to 4
points. (The findings were reported in the December 2006 issue
of the European Respiratory Journal.)

Start Asthma Treatment Early

If emergency room physicians started patients with asthma
on maintenance medication when they arrived at the
hospital, it might help prevent future flare-ups. Researchers
made the recommendation after evaluating a pediatric
emergency department-based program designed to establish
a new role for the emergency room physician.

For the study, reported in Pediatrics (December 2006), the
researchers provided 40 children with persistent asthma
with anti-inflammatory medications, and a letter summarizing
the treatment plan was faxed to the patient's primary
care physician the next day. It was the primary care physicians'
responsibility to prescribe ongoing anti-inflammatory
medication. Of all the participants, 28 followed up with their
primary care physician, and the anti-inflammatory medication
was continued in 21 of them. Overall, one third of the
patients continued on a long-term anti-inflammatory medication
following the emergency room visit.